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Query: UMLS:C0018799 (
heart disease
)
34,133
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The neural crest is involved in the differentiation of the cardiac outflow tract and branchial arches. Branchial arches one and two give rise to the eustachian tubes. Anatomically different eustachian tubes (e.g., short length) are found in persons prone to otitis media. We hypothesized a relationship between outflow tract anomalies and eustachian tube anomalies. The medical records of 238 children with a catheterization diagnosis of congenital
heart disease
were reviewed for
otitis
diagnoses. Children with syndromes known to be associated with recurring otitis media were excluded. Recurrent otitis media was recorded in 32.2% of those with outflow tract anomaly, significantly (P less than 0.03) higher than the 18.9% rate in children with a cardiac anomaly not involving the outflow tract. Neither race, sex, nor cyanosis seemed to account for the differing rates of
otitis
. These data may support the concept of a field defect arising from neural crest cells that influences the development of the cardiac outflow tract and eustachian tubes.
...
PMID:Congenital cardiac outflow tract anomalies and otitis media. 323 84
Fifty-four consecutive cases of children with cerebral abscess from 1958 to 1987 are reviewed. Their average age was 6.6 years, ranging from 3 days to 19 years. A wide range of organisms and underlying diseases was encountered. The predominant mode of surgical therapy was craniotomy with resection of the abscess. Aspiration and craniotomy with drainage-evacuation were also employed in our series. No underlying disease was found in 10 (19%) of the children. Cyanotic
heart disease
(CHD) was present in 13 (24%) of the children. Four children had dental abscesses and 1 had otitis media. Seven (13%) children had abscesses secondary to hydrocephalus/shunt infections. Sinusitis and
otitis
accounted for 5 cases (9%). Four children (7%) had tuberculomas. One abscess was associated with a nasal dermal sinus and one was congenital. Fourteen (26%) patients had negative cultures. Fourteen (26%) abscesses contained streptococci of various types. Staphylococci were found in only 5 (9%) of the abscesses. The congenital abscess was caused by salmonella. Two abscesses (7%) were fungal. Both of these patients died. Six children (11%) were treated without surgical intervention. Three of them died. Forty-eight children had surgical intervention; 12 underwent aspiration, 14 underwent open evacuation of the abscess, and 22 had abscesses resected. Mortality in the aspiration group was twice that of the evacuation or resection group (17, 7 and 9%), respectively). The factor which correlated best with mortality was the patient's clinical status on admission. The advent of CT scan at our facility improved mortality by facilitating accurate diagnosis and surgical intervention. Overall mortality rates decreased from 31 to 5.7% and surgical mortality fell from 21 to 2.9%.
...
PMID:Pediatric cerebral abscess. 327 49
Brain abscess and subdural empyema are serious infections which can be metastasis of chronic suppurative diseases (bronchectasia, lung or abdominal abscesses) or of congenital
cardiopathy
, but they are more frequently seen in healthy adults suffering from chronic sinusitis or
otitis
. Brain CT scan with contrast media injection is the best tool for diagnosis and follow-up. It has transformed the prognosis of brain abscesses. Anaerobic oropharyngeal microflora is the main source of bacteria responsible for suppurative brain diseases. Surgical treatment consists of aspiration or, rarely now, of excision of the lesion. Medical treatment alone can be successful in selected cases, provided patients are closely monitored and antibiotics with good penetration into the brain parenchyma are used.
...
PMID:[Cerebral abscess and empyema]. 798 21
Forty-four consecutive patients with brain abscesses, aged between 1 month and 16 years, were reviewed. The cause of abscess was meningitis in 36% of the cases,
otitis
in 27%, head injury in 16%, congenital
heart disease
in 9%, other in 5%, and undetected in 5%. Thirty patients had a single abscess and 12 had multiple abscesses. Multiloculated abscess was present in 2. Total excision was accomplished in 22 patients. Three patients underwent needle aspiration. Drainage of the abscess was performed in 13. Secondary excision was needed in 5 patients. One patient was treated nonsurgically. Streptococci, staphylococci and Proteus mirabilis were the microorganisms recovered in cultures. Overall mortality was 20% (9 patients). Mortality was significantly higher in patients under 2 years of age than in those older. Of 15 patients who were comatose at the time of admission, 6 died. Etiology, diagnostic method, and treatment modalities were not found to be significant factors in terms of predicting mortality.
...
PMID:Brain abscess in infants and children. 804 16